2022 Volume 35 Issue 4 Pages 313-318
A 15-year-old female patient was transported to our hospital due to altered consciousness after valproic acid (VPA) overdose. She attempted suicide by taking 18 g of sustainedrelease VPA 19 hours before arrival. On admission, she was in a comatose state, her serum NH3 level was high (723 μg/dL), and her serum free carnitine level was low (12.1 mmol/L). Oral intubation, administration of activated charcoal and levocarnitine, and continuous hemodiafiltration were performed. The serum levels of VPA and NH3 decreased immediately. She regained consciousness on day 3 and was discharged on day 9 with no sequelae. Patients with overdose of sustained-release VPA need to be observed for a longer time and carnitine administration should be considered for hyperammonemia.
